Trump Administration New Policy Autho... - Advanced Prostate...

Advanced Prostate Cancer

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Trump Administration New Policy Authorizing and Encouraging Step Therapy

cesanon
cesanon

Trump Administration New Policy Authorizing and Encouraging Step Therapy.

For those of you who don't know, step therapy has traditionally been used to interfere with prostate cancer treatment protocols. Not certain how it will play out with current protocols.

A word to the wise, if you have prostate cancer you probably want to give Medicare Advantage plans a wide berth. Once you sign up for any Medicare plan you will have a problem leaving. Transfers from one plan to another is subject to the pre-existing conditions rule that Obamacare removed from non-Medicare health plans.

"Medicare Advantage plans, which are offered by private companies, will also be able to use step therapy, or starting patients on less expensive options before moving them up to more expensive drugs."

cnbc.com/2018/08/07/trump-a...

11 Replies

Thank you for posting this.

Cant comment on step therapy, but Medicare Advantage HMO is a trap. Always start with Medicare PPO and stay in it. Once you go Medicare Advantage, you cant get out unless you move over 400 miles to a new service area. I moved from SCAL to NCAL and was able to dump Kaiser HMO to get a good PPO plan, now I go to Stanford Health and UC Davis for care.

cesanon
cesanon in reply to abmicro

???? I think the choice is between an advantage plan and regular supplemental insurance.

Are you sure you're taking about a Medicare ppo?

abmicro
abmicro in reply to cesanon

Medicare PPO is a Medicare supplemental plan. That is the best choice for people with advanced prostate cancer. You can go to any doctor, any hospital, anywhere in the USA for treatment or advice. Stay away from HMO plans.

cesanon
cesanon in reply to abmicro

What is the ppo plan you ended up using?

When you moved, were you subject to a pre-existing condition screening?

I was told I won't be able to change Medicare supplemental plans without getting screened for pre-existing conditions (prostate cancer LOL)

I was on Medicare advantage when diagnosed. The next year I switched to Medicare supplemental so I wasn't stuck in some network and could see whatever specialist I wanted to without a referral. I wasn't hassled in the least in making this change.

cesanon
cesanon in reply to WSOPeddie

Wsopeddie

How long ago was that?

WSOPeddie
WSOPeddie in reply to cesanon

I made the switch to supplemental in 2017.

cesanon
cesanon in reply to WSOPeddie

I just looked this up. It seems like you can run into a lot of problems accord to this explaination. But as detailed as it is, it appears to leave a lot of details out. And somehow cancer is treated differently, but it is not clear exactly how. At least to my reading.

Any comments anyone?

planprescriber.com/medicare...

WSOPeddie
WSOPeddie in reply to cesanon

I was helped by a (free) Medicare 'broker' who walked me through the process of signing up with the Medicare Supplemental Plan F. There were some questions of prior history or treatments that didn't seem to affect anything.

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Just the beginning of cuts..

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